Radical Hysterectomy for Non‐Endometrioid Endometrial Cancer With Cervical Involvement: A Retrospective Cohort Study

OBJECTIVE: To evaluate the survival impact of radical hysterectomy versus simple hysterectomy on non-endometrioid endometrial cancer with cervical involvement. METHODS: We conducted a multicenter retrospective cohort study of 422 women with uterine serous carcinoma or uterine clear cell cancer treated between 2013 and 2020 at four tertiary teaching hospitals. We classified the patients by the type of hysterectomy. Overall survival and disease-free survival were analyzed and compared using the Kaplan-Meier method and the log-rank test. To adjust for the potential confounders, the Cox proportional hazards regression model was employed. RESULTS: Our cohort included 275 women who underwent radical hysterectomy and 147 women who underwent simple hysterectomy. The baseline characteristics of the two groups did not differ significantly. There was no statistical difference in recurrence between the two groups (23.8% vs. 20.4%, p = 0.456). Compared with a simple hysterectomy, a radical hysterectomy was not associated with improved overall survival (hazard ratio 0.93, 95% confidence interval 0.69-1.26, p = 0.652), and improved disease-free survival (hazard ratio 0.96, 95% confidence interval 0.72-1.26, p = 0.745). After adjusting for potential confounders, the analysis showed that the type of hysterectomy did not affect overall survival (hazard ratio 0.99, p = 0.968) and disease-free survival (hazard ratio 1.01, p = 0.985) in non-endometrioid endometrial cancer with cervical involvement. CONCLUSION: Radical hysterectomy was not associated with a survival benefit in non-endometrioid endometrial cancer with cervical involvement.